Ongoing cuts to sexual health services will cost UK economy billions, says report

BMJ 2013; 346 doi: (Published 30 January 2013) Cite this as: BMJ 2013;346:f641
  1. Caroline White
  1. 1London

If cuts to sexual health services being made as part of ongoing efficiency savings in the public sector continue, the UK economy could be lumbered with billions of pounds in additional health and social care costs and lost tax revenues by 2020, claims a joint report.

Unprotected Nation,1 from the sexual health charities Brook and the Family Planning Association, was commissioned amid mounting concern that the squeeze on public sector finances and changes in commissioning structures had curbed access to sexual health and contraceptive services across the United Kingdom.

The report—which calculates the long term financial effect on the UK economy of maintaining current access levels, imposing further cutbacks, or reversing the restrictions—draws on the available data on rates and trends in conceptions, abortions, miscarriages, and sexually transmitted infections (excluding HIV) and on projections of UK population growth.

The analysis shows that the public sector could face an extra £8.3bn (€9.7bn; $13bn) to £10bn in additional costs of treatment and welfare between 2013 and 2020 if sexual health and contraceptive services were pared back further, given the resulting cumulative projected rise in sexually transmitted infections and unwanted pregnancies.

But if access to these services were improved, the sector stood to save between £3.7bn and £5.1bn over the same period, it calculates.

Around 510 000 new diagnoses of sexually transmitted infections were made in the UK in 2011, which, on current trends, would cost a cumulative £6bn by 2020. But, if sexual health services were cut back further, this could rise to £6.35bn, warns the report.

The effect of unintended motherhood on income and tax and national insurance revenues could also be substantial, it says. If the current rate of unintended pregnancy continued—estimated to be a cumulative total of just over 3.5 million by 2020—the cumulative total in lost earnings would be £2.51bn. Worsened access would result in just over 3.6 million such pregnancies, adding an additional £122m to that figure. The knock-on effect on the UK economy could amount to between £3.52bn and £3.81bn by 2020, says the report.

It points out that medical costs “pale almost into insignificance” when compared with wider public sector costs, such as housing, education, and initiatives to combat poverty. These range from £73bn to £115.4bn by 2020, on current trends. But, if access to sexual health services were to be further restricted, these could rise to £125bn, says the report. And up to 15% of the UK’s anticipated welfare budget could go on the services needed to support the children from unintended pregnancies, it adds.

In a commentary in the report, the GP Anne Connelly, who chairs the Primary Care Women’s Health Forum, said that the effect of continuing restriction in access to sexual health and contraceptive services was “frightening.”


Cite this as: BMJ 2013;346:f641